7920 EVERGREEN WAY 2025-08-22 - Laserfiche WebLink

Intake & Approval Sheet 'pp (FOR PERMIT STAFF ONLY) PERMIT# � �- BUILDING PLANNING Intake OK by: Date: Intake OK by: Assign To: Date: Intake Comments: Intake Comments: Zone ❑ Make this a"W"Permit ❑ SRC Required(Pre-Insp) Overlay/Agreement Bldg/TI/Addn/Rem Size Nonresidential Use Garage/Accessory Struct.Size Residential Use Number of Stories Proposed No.of Dwelling Units: Basement []No ❑Yes , Fin/Unfin Total No.of Dwelling Units: Type of Construction Planning/Landscape Inspection Required before Final? ❑Yes []No Occupancy Group "In Lieu"Fee:Type: Amount$ Occupancy Load School Impact Fee: Total $ Cert. of Occpuancy Required? []No ❑Yes ❑Shell Only Calculated: Credit: Code Year 02021 ❑2018 112015 ❑Everett School Dist ❑Mukilteo School Dist Fire Sprinklers: []Update Existing El New System El Not Req'd Park Impact Fees for permits applied for after 1/1/2022: Reason Sprinklers Required: Park Impact Fee Total$ (net due after credit for existing uses) Fire Alarm: ❑Update Existing ❑New System []Not Req'd Fee Schedule Used For Calculation(Year): Reason Fire Alarm Required: RCW 64.55 MF worksheet req'd for permit? ❑Yes ❑ No Add'I RCW 64.55 does required prior to final? ❑Yes El No Additional Notes: VALUATION CALCULATION: Total$ Approved By: Date: PUBLIC WORKS Intake OK by: Date: Intake Comments: PW Review&Worksheet Needed If., ❑Sys Dev Eval: Additional Notes: ❑Water []Sewer ❑Storm []Traffic Mitigation Eval Approved Date: L 120 Wit' []Site Work/Drainage(shown/triggered) ❑Address Letter FIRE DEPARTMENT ❑Backflow Prevention for high hazard: Separate/Deferred Submittals Required: (dental,medical,animals,mortuary, El Fire Sprinklers ❑Fire Alarm ❑Other: hospital,supportive housing) Additional Notes: ❑ This Permit is Approved by Public Works ❑ See PW Review Worksheet and associated attached items Fire Dept. Fees: ❑ A Separate PW Permit is Required (Permit#: PW ) ❑ Review of As-Built Plans-NO FIRE FEE AND ❑ Is fully digital ❑ Minimal or No Fire Scope-NO FIRE FEE ❑ Is located in this folder ❑ Review/Inspection Scope-ADD FIRE FEE ❑ Is in a Separate Green Folder(join with this folder for permit issuance) Approved By: Date: ❑ Will be Issued separately(Separate Green Folder,PW issued ahead of Bldg) ❑ Public Works has no scope on this permit--- PW Not Required ELECTRICAL/PLUMBING Additional Notes: Additional Notes: Approved By: Date: Completed By: Date: